Er Nurses

16
Just wanted to say, I thank you for what you do. Even though I think that sometimes you have no idea what I do, I.....in the same sense, don't understand exactly what hurdles you are up against. So, if I ever anger you, or offend you, I don't mean to. It's just I'm frustrated as much as you. Could you please just understand that when you call for report, it's possible that I can't answer that phone call at that given time? I'm in the middle of trying to stablize my pt who won't quit going into V-Tach? Or, I could be in the middle of explaining that all the treatment we are trying to do is not working on this CHF pt to the family? I'm not against you. I'm in this business for the same reasons you are. Because I want to help people. What I do is just as important as what you do. And, I must say, I don't think I could do your job. You are exposed to many things unbecoming that I am not. And for that, I respect you. But, could you please try to understand that I'm not avoiding your phone call? I'm just busy trying to make sure that my pt won't code while I'm trying to take report from you. Thanks for listening.

Just wanted to say, I thank you for what you do. Even though I think that sometimes you have no idea what I do, I.....in the same sense, don't understand exactly what hurdles you are up against. So, if I ever anger you, or offend you, I don't mean to. It's just I'm frustrated as much as you. Could you please just understand that when you call for report, it's possible that I can't answer that phone call at that given time? I'm in the middle of trying to stablize my pt who won't quit going into V-Tach? Or, I could be in the middle of explaining that all the treatment we are trying to do is not working on this CHF pt to the family? I'm not against you. I'm in this business for the same reasons you are. Because I want to help people. What I do is just as important as what you do. And, I must say, I don't think I could do your job. You are exposed to many things unbecoming that I am not. And for that, I respect you. But, could you please try to understand that I'm not avoiding your phone call? I'm just busy trying to make sure that my pt won't code while I'm trying to take report from you. Thanks for listening.

I understand where you're coming from. What gets me is when I was on the floor, I'd take report for another nurse who was busy and hand off the sheet to her. No one does that (very rarely, at most) anymore... why is that? I help out my fellow nurses all the time if I can...

Just wanted to say, I thank you for what you do. Even though I think that sometimes you have no idea what I do, I.....in the same sense, don't understand exactly what hurdles you are up against. So, if I ever anger you, or offend you, I don't mean to. It's just I'm frustrated as much as you. Could you please just understand that when you call for report, it's possible that I can't answer that phone call at that given time? I'm in the middle of trying to stablize my pt who won't quit going into V-Tach? Or, I could be in the middle of explaining that all the treatment we are trying to do is not working on this CHF pt to the family? I'm not against you. I'm in this business for the same reasons you are. Because I want to help people. What I do is just as important as what you do. And, I must say, I don't think I could do your job. You are exposed to many things unbecoming that I am not. And for that, I respect you. But, could you please try to understand that I'm not avoiding your phone call? I'm just busy trying to make sure that my pt won't code while I'm trying to take report from you. Thanks for listening.

mamason- Hey - I am an ER nurse, but I workedon various inpatient units for about 10 yrs. before becoming an ER nurse. You do have a valid point in that we as ER nurses do give floor staff a hard time, so to speak, about not being available when the ER staff calls. Been there, having up to 10 to 12 patients some with rather demanding family members, you sometimes can not just drop whatever you are doing to come to the phone for report! A good bit of the time floor nurses are busy stabilizing another patient to keep them from coding or crashing on the floor. (Especially where I work, when we have a code upstairs and ICU is full, they go to the ER.)

I understand where you're coming from. What gets me is when I was on the floor, I'd take report for another nurse who was busy and hand off the sheet to her. No one does that (very rarely, at most) anymore... why is that? I help out my fellow nurses all the time if I can...

I want to take my own report, because I want to be able to ask my own questions and get a true idea of what is coming. It is the same reason that I don't want to take report from some nurse that has never assessed the patient and is just giving report from the ER charge sheet. I could get information that way myself. The idea behind calling personal report is just that- that the person taking care of the patient in one department speak to the person that will be taking care of them in the next. If the nurse on the floor is too busy to take report- they are probably too busy to take the patient right that minute too

Sorry- don't mean to be snippy- can you tell that this is one of my pet peeves?

Ya know the thing that gets me about the ER. Antecubital IV starts. You start them there, they come to the floor and if they need IV fluids, people sleep with their arms bent and the darn things beep all night and I usually have to resite them. Understandable that sometimes depending on the patients status when they arrive they may need quick access and the AC is usually the best place to go. That is not the case most times. Floor nurses have a hard time appreciating the incredibly hard job that the ER faces in trying to get patients to the floor and free up beds. ER nurses have a hard time appreciating the position of the floor nurses and that they are not sitting around waiting for ER report. It is important for us to all realize that we are a team and we should work together. I always take report when ER calls, unless Im in a room gowned up or in the middle of a task that I can't drop. Remember we have to pick our battles. Im lucky that I have run into very few ER nurses that demand that I take report right then and there when they call. It also doesnt bother me if another nurse takes report for me, either way I will have to look up that patients information and assess them. A positive attitude and an appreciation for what all nurses are faced with will help all of us.

I've been a floor nurse and I'm currently an ER Nurse so I do see both sides to this debate. However, I want to point out that when a patient comes up to your unit with an IV in the AC site, please keep in mind that the medics often start the IV's while en route to the ER. More often than not, I find that to be their site of choice, not ours. I don't fault them for that though because I'm thankful to have IV access of any kind and it just makes my job that much easier- sorry it doesn't help you in that aspect. In their defense, I can't imagine how hard it would be to start an IV with the squad speeding down the road hitting bumps and dodging traffic. I hardly ever see ER nurses picking an AC as the preferred IV site unless that is the only thing they have left or, like another poster mentioned, they need to have a larger vein to dump fluids in.
I do understand the frustration of the positional IV and running down that hall every few minutes to reset the pump. A lot of times I propped the patient's arm up on a pillow, secured it to an arm board or casually mentioned to them that I may need to obtain access elsewhere if the two of us couldn't come up with a good plan to keep that IV infusing properly. Usually, the fear of being re-stuck often motivated my patient to make a conscious effort to keep the site from occluding.

I want to take my own report, because I want to be able to ask my own questions and get a true idea of what is coming. It is the same reason that I don't want to take report from some nurse that has never assessed the patient and is just giving report from the ER charge sheet. I could get information that way myself. The idea behind calling personal report is just that- that the person taking care of the patient in one department speak to the person that will be taking care of them in the next. If the nurse on the floor is too busy to take report- they are probably too busy to take the patient right that minute too

Sorry- don't mean to be snippy- can you tell that this is one of my pet peeves?

but what I mean is to keep the flow going, help your fellow nurse out - I take report from EMS on a patient who won't be mine, but I do the triage and VS to get one portion out of the way. You always go in there to assess them anyway as the primary. Getting report from another floor is just an overview anyway - it shouldn't hold things up to get a one to one report. Besides, when the ER calls, that nurse likely just assumed care and doesn't know jack about that person (like at shift change) - so what, then. That's not helping you out, because they're reading from the previous shift report and we don't have time to review everything. It IS just best to have someone take report (if they'd be so helpful) when your hands are full and you'll get a better idea when they get to the floor..... it's one of my pet peeves, too, to hear "she's on a break, or eating" meanwhile I'm digesting my spine from my own hunger - we don't get breaks (EVER) and to use that as an excuse is unacceptable - there is always a nurse covering so that one is able to take a break who can take report. At least that's how it should be, legally....

Ya know the thing that gets me about the ER. Antecubital IV starts. You start them there, they come to the floor and if they need IV fluids, people sleep with their arms bent and the darn things beep all night and I usually have to resite them.

If I may, I'd like to explain why that sometimes happens.

Often, if a pt arrives to the ER and is SOB, possibly needing a Chest CT, we go for the AC because the CT techs will not give the IV contrast through anything smaller than a 20, anywhere lower than the AC.

I don't know what the policy is at other places, but I know we will do it on a case by case basis to make sure that the patient doesn't wait for their test because we have to place another IV.

That being said, some patients just have no veins... and some nurses are too lazy to look at hands and forearms!

Here's to hoping we can all appreciate each other's workplace struggles